Annali italiani di chirurgia
-
Aim of this paper is to allows to analyze a topic of great relevance and media interest such as the role of prophylactic mastectomy in healthy women with BRCA mutation proposing to the surgeons some useful informations for decision-making. Less than 15% of all breast cancers are associated with germline genetic mutations. The majority of hereditary breast tumors are due to mutations in BRCA1 and BRCA2 genes that are responsible for only one third of hereditary cases. ⋯ A personalized multidisciplinary path should guarantee an accurate genetic and clinical counselling, adequate psychological support and detailed information about all alternative risk management strategies. Clinical decision-making about strategies to pursue for breast cancer risk reduction should involve a tradeoff between life expectancy and quality of life. However if the patient and the medical team opt to proceed with prophylactic surgery, the cumulative evidence to date supports nipple sparing mastectomy with immediate reconstruction as an appropriate risk-reducing procedure to optimize the oncological and aesthetic results and improve quality of life.
-
Editorial Comparative Study
[Multiple abdominal trauma: therapeutical options].
To revise a series of multiple abdominal trauma in order to evaluate the type of diagnosis process and therapy undertaken, the complication and patient survival rates. ⋯ Non operative management of multiple abdominal injury seems to be feasible in a small percentage and possibly only in selected cases.